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Objectives: The aim of the study was to investigate fear of falling, kinesiophobia, and sensory processing in older adults with hypertension and normotension., Methods: Older adults, 62 with hypertension and 62 with normotension, aged 65-84 years were included in the study. The assessment of fear of falling was conducted using the Tinetti Falls Efficacy Scale, kinesiophobia was evaluated with the Tampa Kinesiophobia Scale, and sensory processing skills were analyzed with the Adolescent/Adult Sensory Profile., Results: Significant differences were found between the groups in terms of vestibular processing, visual processing and activity level, fear of falling and kinesiophobia ( p  < .05). No significant differences were found between the groups with respect to taste/smell, tactile, and auditory processing skills. The findings revealed that older adults with hypertension exhibited diminished vestibular and visual processing abilities, reduced activity levels, and heightened concerns about falling and a tendency to experience kinesiophobia. Fear of falling and kinesiophobia were found to increase with decreasing vestibular processing skills and activity levels in both groups ( p  < .05). Regression analysis revealed that age, kinesiophobia, vestibular processing, and activity levels were significant determinants of fear of falling ( p  < .05)., Conclusion: It is recommended that older adults with hypertension be assessed in terms of sensory, functional, and mental health, with the objective of planning appropriate intervention approaches.

To explore relationships among low back pain knowledge, fall fear, exercise self-efficacy and kinesiophobia in pregnant women with pregnancy-related low back pain (PLBP) through a chain mediating model. This study used a cross-sectional survey and utilized convenience sampling from August to December 2023 at a third-class hospital in Wuxi, China. A total of 325 PLBP pregnant women were chosen as the subjects of this study. Sociodemographics and information about low back pain knowledge, low back pain knowledge, fall fear, exercise self-efficacy, and kinesiophobia were collected. Path analysis was used to analyze the cross-sectional data. The results of this study found that low back pain knowledge can directly affect kinesiophobia (β = -0.489, p < 0.001). Fall fear and exercise self-efficacy play a significant mediating role between low back pain knowledge and kinesiophobia, with an overall mediating effect value of 0.202. After including fall fear and exercise self-efficacy, the direct effect value of low back pain knowledge on kinesiophobia was - 0.287. Low back pain knowledge in PLBP pregnant women can significantly and negatively predict their kinesiophobia. Between low back pain knowledge and kinesiophobia, there was not only an independent mediating effect of fall fear and exercise self-efficacy but also a chain mediating effect., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Ankylosing spondylitis (AS) is a chronic rheumatic disease that predominantly affects the axial skeleton, causing pain and functional impairment. Kinesiophobia, or fear of movement, is common in patients with chronic pain conditions and can significantly hinder treatment outcomes. This study aims to assess the level of kinesiophobia in AS patients and explore its relationship with demographic characteristics, disease duration, pain intensity, disease activity, and functional impairment., Methods: This single-center study included 35 AS patients from July 2021 to July 2023. Patient demographics, disease duration, disease activity (BASDAI (Bath Ankylosing Spondylitis Disease Activity Index)), functionality (BASFI (Bath Ankylosing Spondylitis Functional Index)), pain intensity (VAS (Visual Analog Scale)), and kinesiophobia (TSK (Tampa Scale of Kinesiophobia)) were recorded and analyzed. Patients were categorized into low and high kinesiophobia groups based on TSK scores., Results: Of the 35 AS patients, 15 (42.86%) had high kinesiophobia levels (TSK ≥37). Patients with high kinesiophobia had significantly higher BASDAI, BASFI, and VAS scores ( p < 0.001) compared to those with low kinesiophobia. No significant relationship was found between kinesiophobia and age, gender, or disease duration ( p > 0.05)., Conclusion: High levels of kinesiophobia in AS patients are associated with increased pain, disease activity, and functional impairment. Early interventions targeting kinesiophobia could improve treatment outcomes and patient functionality., Competing Interests: The authors declare that they have no competing interests., (© 2025 Ertem.)

Primary malignant bone tumors are significant health concerns in children. These tumors, often accompanied by pain, fatigue, and reduced physical function, can lead to the development of kinesiophobia, a fear of movement that can further complicate rehabilitation. Although factors associated with kinesiophobia have been examined in various adult cancer populations, there is limited research on kinesiophobia and its predictors in children with bone tumors. This study aims to investigate the factors contributing to kinesiophobia in pediatric bone tumor patients. This prospective cross-sectional study was conducted in children with primary malignant bone tumors aged 8-17 years who actively on treatment. The Tampa Scale for Kinesiophobia (TSK) was used to assess fear of movement. Other assessments included the numerical rating scale (NRS) for pain, the PedsQL™ Multidimensional Fatigue Scale for fatigue, the Children Depression Rating Scale-Revised (CDRS-R) for depression, manual muscle testing, and the TUG Test for functionality. Logistic regression was performed to identify predictors of kinesiophobia, while chi-square tests examined the relationship between muscle strength and kinesiophobia levels. One hundred children with bone tumors an average age of 11.83 years participated in the study. The logistic regression model indicated that surgery status, pain levels, and fatigue were significant predictors of kinesiophobia, with an R 2 value of 0.870, explaining 87% of the variance in kinesiophobia levels. Children who had surgery and were in more pain and had higher levels of depression were more likely to exhibit kinesiophobia., Conclusion: This study highlights the multifactorial nature of kinesiophobia in children with malignant bone tumors, emphasizing the roles of surgical status, pain, and psychological factors. Integrating biopsychosocial assessments and approaches into routine care may be important to reduce kinesiophobia, improve rehabilitation outcomes, and increase overall well-being., What Is Known: • Kinesiophobia has been studied in adult cancer populations and has been associated with decreased physical activity and poorer rehabilitation outcomes., What Is New: • This study demonstrates that surgery status, pain levels, and fatigue are significant predictors of kinesiophobia in children with malignant bone tumors and highlights that, in addition to various cancer-related symptoms, kinesiophobia can also be present in this population., Competing Interests: Declarations. Ethical approval: The study was approved by the local institutional ethical board (University Non-Interventional Clinical Research Ethics Committee) with registration number (E54022451-050.04.-144673). Written informed consent was obtained from all participants based on the principles stated in the Declaration of Helsinki. Informed consent: All respondents and signed informed consent forms for participation. Consent for children was given by their parents. Child assent forms were also obtained. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: Fear of movement in patients with traumatic hand-arm injuries can negatively affect functional outcomes. Therefore, it is important to evaluate fear of movement in this patient population. The aim of this study was to investigate the validity and reliability of the Tampa Scale for Kinesiophobia in patients with traumatic hand-forearm injuries., Design: Cross-sectional., Setting: Hand rehabilitation unit in a university hospital., Participants: The study included 170 patients with traumatic hand-arm injuries and a mean age of 37.57 (11.85) years., Main Measures: Tampa Scale for Kinesiophobia , Pain Catastrophizing Scale, Beck Anxiety Inventory and pain severity rating (via Visual Analog Scale) were completed by interview in the first session. In addition, Modified Hand Injury Scoring System was used to determine severity of the injury. Tampa Scale for Kinesiophobia was re-administered 15 days after the first session. Test-retest reliability, internal consistency, and construct validity of the Tampa Scale for Kinesiophobia were evaluated. In addition, exploratory factor analysis was completed using baseline data., Results: Cronbach's alpha for the scale was 0.604, and test-retest reliability was acceptable (ICC = 0.646). Tampa Scale for Kinesiophobia had a significant relationship with Beck Anxiety Inventory ( r  = 0.269, p  < 0.001), Pain Catastrophizing Scale ( r  = 0.457, p  < 0.001) and pain severity at rest ( r  = 0.168, p  = 0.029). Factor analysis estimated the scale represented five subsections in this population., Conclusions: Psychometric properties of the Tampa Scale for Kinesiophobia were acceptable in patients with hand-forearm injuries. However, since our results were weaker than those in the literature, this should be considered when interpreting the results., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: This study aimed to evaluate kinesiophobia levels in patients with osteoporosis compared to healthy controls and investigate the associations with pain, depression, anxiety, fear of falling, and quality of life., Methods: The study involved 60 postmenopausal osteoporosis patients and 60 healthy controls aged 50 years and above. Kinesiophobia was assessed using the Tampa Scale for Kinesiophobia, while quality of life, psychological symptoms, and fear of falling were evaluated using the Quality of Life Questionnaire of the European Foundation for Osteoporosis, Hospital Anxiety and Depression Scale, and Tinetti Falls Efficacy Scale., Results: Kinesiophobia levels were significantly higher in the osteoporosis group compared to controls (p<0.05). Positive correlations were observed between kinesiophobia and Falls Efficacy Scale (r=0.278, p=0.002), as well as with Quality of Life Questionnaire of the European Foundation for Osteoporosis physical function scores (r=0.185, p=0.043). No significant relationship was found between kinesiophobia and depression or anxiety scores., Conclusion: Kinesiophobia is notably higher in osteoporosis patients compared to healthy individuals, correlating with an increased fear of falling and reduced physical function. Early identification and management of kinesiophobia are essential to prevent reduced physical activity and associated risks, such as decreased bone mineral density and higher fracture risk.

Objectives: After cardiac surgery, there may be barriers to being physically active. Patients are encouraged to gradually increase physical activity, but limited knowledge exists regarding postoperative physical activity levels. This study aimed to assess patient-reported physical activity six months after cardiac surgery, determine adherence to WHO's physical activity recommendations, and explore potential relationships between pain, dyspnea, fear of movement, and activity levels., Methods: The study design was a cross-sectional study at Örebro University Hospital, Sweden. Preoperative and surgical data were retrieved from medical records and questionnaires concerning physical activity (Frändin-Grimby Activity Scale, the Physical activity Likert-scale Haskell, Patient-Specific Functional Scale, and Exercise Self-efficacy Scale) were completed six months after surgery. Data were collected on pain, dyspnea, general health status and kinesiophobia i.e. fear of movement, using the Tampa Scale of Kinesiophobia Heart., Results: In total, 71 patients (68 ± 11 years, males 82%) participated in this study. Most patients (76%) reported a light to moderate activity level (Frändin-Grimby levels 3-4) six months after cardiac surgery. In total, 42% of the patients adhered to the WHO's physical activity recommendations (150 min/week). Pain and dyspnea were low. Patients with lower activity levels exhibited significantly higher levels of fear of movement ( p =.025)., Conclusions: The majority of patients reported engaging in light to moderate activity levels six months after cardiac surgery. Despite this, less than half of the patients met the WHO's physical activity recommendations. Potential barriers to physical activity such as pain, dyspnea and fear of movement were reported to be low.

Kinesiophobia, the fear of movement, can significantly impede an individual's ability to engage in daily activities. This fear often stems from past traumatic experiences or witnessing others in pain, leading to an increased fear of injury. This study aimed to evaluate the psychometric properties of the Persian version of the Tampa Scale for Kinesiophobia among Iranian post-surgery patients. A methodological study conducted in 2023 involved a sample of 400 post-surgery patients selected through convenience sampling. The translated scale underwent psychometric evaluation, including network analysis, exploratory and confirmatory factor analysis for construct validity, as well as assessments for convergent and discriminant validity. Internal consistency of the scale was also assessed. The mean age of the participants was 44.38 (SD = 13.49) years and the majority of them (77.8%) were women. Exploratory factor analysis with Promax rotation identified two factors explaining 60.28% of the variance, comprising 17 items. The final model was confirmed after necessary adjustments in confirmatory factor analysis. Both convergent and discriminant validity were established, and alpha and omega coefficients of the subscales were above 0.7. The Persian version of the Tampa Scale for Kinesiophobia showed robust psychometric properties among Iranian post-surgery patients, serving as a valuable tool for evaluating and addressing kinesiophobia in this population. These findings enhance the understanding and management of kinesiophobia within the Iranian healthcare context., (© 2024. The Author(s).)

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease associated with pain, disability, and functional limitations. Kinesiophobia, the fear of movement, has been linked to disability and pain in KOA patients. This study aimed to analyze the relationship between kinesiophobia and symptoms of KOA. A comprehensive literature search was conducted in four electronic databases (PubMed/Medline, Web of Science, Scopus and Science Direct) with the following inclusion criteria: 1) recruited participants with diagnostic of knee osteoarthritis; 2) measures of pain, disability and/or functional limitation through questionnaires or physical tests; 3) articles exploring the correlation between kinesiophobia, and pain, disability, and/or functional limitation as principal or secondary outcome; 4) primary data studies (observational and experimental). A total of 17 studies involving 1,574 participants (mean age 61.04 ± 5.79 years) were included in the corresponding meta-analyses. Results showed a moderate correlation between kinesiophobia and disability (r = 0.519; p-value=0.004), and fair correlations of kinesiophobia with pain (r = 0.362; p-value<0.001), and functional limitation (r = 0.270; p-value<0.001). Despite high heterogeneity (I 2 : 89.4% for pain, 94.6% for disability, and 90.4% for functional limitation), 52% of studies displayed low risk of bias. In conclusion, kinesiophobia positively correlates with pain, disability, and functional limitation in KOA patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: Kinesiophobia refers to an irrational fear of physical activities or functional exercise due to the fear of pain or reinjury. Cancer patients who undergo esophagectomy are prone to developing kinesiophobia, which adversely affects their disease prognosis and quality of life. Somatic symptoms are closely related to kinesiophobia, but the mechanisms underlying this relationship remain unclear. Therefore, the current study aimed to explore the chain-mediation roles of intrusive rumination and avoidant coping in the relationship between somatic symptoms and kinesiophobia in cancer patients who underwent esophagectomy., Methods: A cross-sectional study was conducted in China from February 2023 to December 2023. A total of 279 postesophagectomy cancer patients were evaluated using the Symptom Check List 90 (SCL-90), Event Related Rumination Inventory (ERRI), Medical Coping Modes Questionnaire (MCMQ), and Tampa Scale of Kinesiophobia (TSK-11)., Results: Kinesiophobia was significantly positively correlated with somatic symptoms, intrusive rumination, and avoidant coping (p < 0.001). Somatic symptoms had a direct association with kinesiophobia (β = 0.280, 95% CI (0.200, 0.360), p < 0.001). Furthermore, our model showed that somatic symptoms had a significant indirect association with kinesiophobia through the separate mediating effects of intrusive rumination (β = 0.204, 95% CI (0.145, 0.267), p < 0.001) and avoidant coping (β = 0.049, 95% CI (0.019, 0.088), p < 0.001), as well as through the chain-mediated effects of intrusive rumination-avoidant coping (β = 0.026, 95% CI (0.012, 0.044), p < 0.001)., Conclusions: The findings of this study suggested that intrusive rumination and avoidant coping play separate and chain-mediated roles in the relationship between somatic symptoms and kinesiophobia in postesophagectomy cancer patients., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Physical activity avoidance and fear of movement (FOM) is often observed in individuals with chronic musculoskeletal pain, along with difficulties coping with pain. There is little research regarding how FOM may also relate to reduced physical strength and altered movement patterns that may perpetuate a cycle of pain, FOM, and disability. The objective of this observational study was to compare how adolescents with juvenile fibromyalgia (JFM) exhibiting high versus low FOM (Tampa Scale of Kinesiophobia-11) differed on patient-reported measures of pain, fatigue, catastrophizing and pain interference, and performance-based measures of strength, postural control, and biomechanical function. Participants were youth with JFM (N = 135, Mean age = 15.6 years, 88.9% female) enrolled in an ongoing clinical trial who completed self-report questionnaires and standardized tests, including knee and hip strength, the Star Excursion Balance Test, and the Drop Vertical Jump (with 3 dimensional motion capture). Participants were categorized into Low, Medium, and High FOM groups based on Tampa Scale of Kinesiophobia-11 tertile scores. Relative to the Low FOM group, the High FOM group reported significantly greater fatigue, pain interference and catastrophizing, as well as reduced dominant leg knee strength. Additionally, those with high FOM showed altered lower-extremity movement patterns. This preliminary study highlights the importance of combining self-reported measures of symptoms and functioning with physical assessments to gain a more comprehensive view of the impact of FOM in patients with chronic musculoskeletal pain. The results could inform the development of more precise interventions to reduce FOM using a combination of behavioral and exercise-based interventions., Perspective: The results of this study demonstrate the association between FOM, fatigue and pain interference in adolescents with JFM, as well as preliminary evidence for altered movement patterns in that may predispose them to further pain/injury and activity avoidance., Gov Registration: NCT03268421., (Copyright © 2024 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Health professionals are regularly confronted with patients suffering from a fear of movement-related pain (unknown as kinesiophobia). The fear-avoidance attitudes and beliefs of healthcare professionals are likely to play a key role in their patients' therapeutic approach. However, kinesiophobia among health professionals is a relatively young topic. This scoping review aims to explore and catalogue the extent of scientific research that identifies the causes and consequences of kinesiophobia among health professionals while they perform their interventions. The review was based on the Joanna Briggs Institute manual and the PRISMA method for a scoping review. The research was conducted in May 2024 using CINHAL, Medline and Sportdiscus databases with the search terms "fear-avoidance", "kinesiophobia", "pain-related" and "physical therapist". Out of 2,162 potential studies, thirteen articles were included. No study directly mentioned kinesiophobia among health professionals, but it was studied through fear-avoidance beliefs. Two-thirds of the articles indicate that professionals with fear-avoidance beliefs tend to refer their patients to other specialists less frequently and limit their patients' activity, despite treatment guidelines. Most of the studies found were physiotherapists' interventions for chronic back pain patients. The current review emphasizes the need for additional studies involving more healthcare professionals and diverse health conditions., Competing Interests: The authors declare there are no competing interests., (©2024 Doutre et al.)

Excessive muscle co-contraction is one of the factors related to the progression of knee osteoarthritis (OA). A previous study demonstrated that pain, joint instability, lateral thrust, weight, and lower extremity alignment were listed as factors affecting excessive co-contraction in knee OA. However, this study aimed to assess the association between fear-avoidance beliefs and muscle co-contraction during gait and stair climbing in people with knee OA. Twenty-four participants with knee OA participated in this cross-sectional study. Co-contraction ratios (CCRs) were used to calculate muscle co-contraction during walking and stair climbing, using surface electromyography. Fear-avoidance beliefs were assessed by the Tampa Scale for Kinesiophobia-11 (TSK-11) for kinesiophobia and the Pain Catastrophizing Scale (PCS) for pain catastrophizing. Secondary parameters that may influence co-contraction, such as degree of pain, lateral thrust, weight, and lower extremity alignment, were measured. The relationships between the CCR during each movement, TSK-11, and PSC were evaluated using Spearman's rank correlation coefficient and partial correlation analysis, adjusted by weight and lower extremity alignment. Partial correlation analysis showed a significant correlation only between medial muscles CCR and TSK-11 during stair descent (r = 0.54, p < 0.05). Our study revealed that kinesiophobia could be associated with co-contraction during stair descent in people with knee OA.

Objectives: To evaluate the effect of combining pain education and virtual reality (VR) exposure therapy using a cognitive-behavioral therapy-informed approach (virtual reality-based cognitive behavioral therapy [VR-CBT]) on pain intensity, fear of movement, and trunk movement in individuals with persistent low back pain., Materials and Methods: Thirty-seven participants were recruited in a single cohort repeated measures study, attending 3 sessions 1 week apart. The VR-CBT intervention included standardized pain education (session 1) and virtual reality-based exposure therapy (VRET; session 2) incorporating gameplay with mixed reality video capture and reflective feedback of performance. Outcome measures (pain intensity, pain-related fear of movement (Tampa Scale of Kinesiophobia), and trunk kinematics during functional movements (maximum amplitude and peak velocity) were collected at baseline (session 1) and 1 week after education (session 2) and VRET (session 3). One-way repeated measures analysis of variances evaluated change in outcomes from baseline to completion. Post hoc contrasts evaluated effect sizes for the education and VR components of VR-CBT., Results: Thirty-four participants completed all sessions. Significant ( P < 0.001) reductions were observed in mean (SD) pain (baseline 5.9 [1.5]; completion 4.3 [2.1]) and fear of movement (baseline 42.6 [6.4]; completion 34.3 [7.4]). Large effect sizes (Cohen d ) were observed for education (pain intensity: 0.85; fear of movement: 1.28), whereas the addition of VRET demonstrated very small insignificant effect sizes (pain intensity: 0.10; fear of movement: 0.18). Peak trunk velocity, but not amplitude, increased significantly ( P < 0.05) across trunk movement tasks., Conclusion: A VR-CBT intervention improved pain, pain-related fear of movement, and trunk kinematics. Further research should explore increased VR-CBT dosage and mechanisms underlying improvement., Competing Interests: This project was completed with funding support through the Royal Brisbane and Women’s Hospital (RBWH) Foundation and the Physiotherapy Department at RBWH, Brisbane, Australia. The authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Musculoskeletal trauma often leads to lasting psychological impacts stemming from concerns of future injuries. Often referred to as kinesiophobia or re-injury anxiety, such concerns have been shown to hinder return to physical activity and are believed to increase the risk for secondary injuries. Screening for re-injury anxiety is currently restricted to subjective questionnaires, which are prone to self-report bias. We introduce a novel approach to objectively identify electrocortical activity associated with the threat of destabilising perturbations. We aimed to explore its feasibility among non-injured persons, with potential future implementation for screening of re-injury anxiety. Twenty-three participants stood blindfolded on a translational balance perturbation platform. Consecutive auditory stimuli were provided as low (neutral stimulus [CS - ]) or high (conditioned stimulus [CS + ]) tones. For the main experimental protocol (Protocol I), half of the high tones were followed by a perturbation in one of eight unpredictable directions. A separate validation protocol (Protocol II) requiring voluntary squatting without perturbations was performed with 12 participants. Event-related potentials (ERP) were computed from electroencephalography recordings and significant time-domain components were detected using an interval-wise testing procedure. High-amplitude early contingent negative variation (CNV) waves were significantly greater for CS + compared with CS - trials in all channels for Protocol I (> 521-800ms), most prominently over frontal and central midline locations (P ≤ 0.001). For Protocol II, shorter frontal ERP components were observed (541-609ms). Our test paradigm revealed electrocortical activation possibly associated with movement-related fear. Exploring the discriminative validity of the paradigm among individuals with and without self-reported re-injury anxiety is warranted., (© 2024. The Author(s).)

Background: Kinesiophobia after percutaneous coronary intervention (PCI) may lead to decreased compliance with rehabilitation exercises. Effective interventions are essential to overcome kinesiophobia after PCI. The aim of this trial is to investigate the clinical effects of an intervention based on the fear-avoidance model (FAM) on kinesiophobia in post-PCI patients., Methods: Eighty participants will be recruited in the Department of Cardiology in Hebei Provincial People's Hospital. And they will be randomly allocated to the test group and undergo a 5-day step-to-step intervention. The primary outcome will be the scores of a scale on kinesiophobia. Secondary outcome measures included self-efficacy for exercise, psychogenic anxiety, and the occurrence of cardiovascular adverse events. Primary and secondary outcome data will be collected at baseline (t 0 ), on the day of discharge (t 1 ), and one month after discharge (t 2 )., Discussion: The effectiveness of an intervention based on the FAM to increase exercise self-efficacy and decrease kinesiophobia in post-PCI patients will be demonstrated. The findings of this study will facilitate post-PCI patients to participate in cardiac rehabilitation., Trial Registration: ChiCTR2200065649 Effect of an intervention based on the fear-avoidance model on exercise fear in patients after percutaneous coronary intervention. Registered on November 10, 2022., (© 2024. The Author(s).)

Background: With a prevalence of 7-30%, shoulder disorders form the third largest group of musculoskeletal complaints. Their formation and development is influenced by, e.g. psychological factors. The Tampa scale for kinesiophobia (TSK) is the most common measure for quantifying fear of movement., Objectives: To investigate the reliability and validity of the German version of the TSK (TSK-GV) in a shoulder pain population., Materials and Methods: Subjects with shoulder pain were included in a multicenter cross-sectional study. In addition to kinesiophobia, pain intensity, subjective impairment in daily life and fear-avoidance beliefs were recorded., Results: A total of 49 subjects (24 women and 25 men) with a mean age of 41.8 (SD = 12.8) were included. The descriptive evaluation at item level showed good internal consistency (Cronbach's α = 0.81). The homogeneity of the scale is poor (Loevinger's H = 0.35). The correlations did not show any clear convergence of the TSK-GV with the fear-avoidance beliefs questionnaire (FABQ) (r = 0.3501; p = 0.0137). The divergent validity was confirmed for both the numerical rating scale (NRS) (r = 0.1216; p = 0.4052) and the shoulder pain and disability index (SPADI) (r = 0.2571; p = 0.0745). The hypothesis testing resulted in 28.57% accepted hypotheses. There was a significant influence of the TSK-GV and the FABQ on the duration of complaints (R 2  = 0.3652; p ≤ 0.0001), as well as an explained variance of the duration of complaints on the TSK-GV of R 2  = 0.1834 (p = 0.0021). The subgroup analysis showed a significantly higher degree of kinesiophobia in male subjects (t = 3.8084/df = 47; p = 0.0002)., Conclusion: The TSK-GV is a reliable measurement tool. The construct validity should be further investigated in future studies. This study shows comparable values to previous studies in other populations. The TSK-GV is to date the only validated German language measure for recording fear of movement in shoulder disorders and shows an acceptable fit for this population., (© 2022. The Author(s).)

Background: Little is known about the association between fear of movement (kinesiophobia) and objectively measured physical activity (PA), the first 12 weeks after cardiac hospitalization., Purpose: To assess the longitudinal association between kinesiophobia and objectively measured PA and to assess the factor structure of kinesiophobia., Methods: We performed a longitudinal observational study. PA was continuously measured from hospital discharge to 12 weeks using the Personal Activity Monitor. The PAM measures time spent per day in PA-intensity categories: light, moderate and heavy. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK) at four time points (hospital discharge, 3, 6 and 12 weeks). The longitudinal association between PA-intensity and kinesiophobia was studied with a random intercept cross lagged panel model (RI-CLPM). A RI-CLPM estimates effects from kinesiophobia on objectively measured PA and vice versa (cross-over effects), and autoregressive effects (e.g. kinesiophobia from one occasion to the next)., Results: In total, 116 patients (83.6% male) with a median age of 65.5 were included in this study. On no occasion did we find an effect of kinesiophobia on PA and vice versa. Model fit for the original model was poor (X2: = 44.646 P<0.001). Best model fit was found for a model were kinesiophobia was modelled as a stable between factor (latent variable) and PA as autoregressive component (dynamic process) (X2 = 27.541 P<0.12)., Conclusion: Kinesiophobia and objectively measured PA are not associated in the first 12 weeks after hospital discharge. This study shows that kinesiophobia remained relatively stable, 12 weeks after hospital discharge, despite fluctuations in light to moderate PA-intensity., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Keessen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Fear of movement has been related to lower limb activation patterns in older adults. However, insight into consecutive perturbations on stepping strategy while considering fall-related confidence is unknown., Research Question: Are there latency time delays following three consecutive slip perturbations between subjects with and without kinesiophobia when considering limb dominance and fall efficacy differences?, Methods: There were 15 older adults with kinesiophobia and 15 age- and body mass index (BMI)-matched control subjects. The subjects stood on the platform during three consecutive perturbations (250, 300, and 400 msec excursions), which were produced by a Bertec device. The subjects completed questionnaires to evaluate the psychological features of their fall-related fear (Tampa Scale for Kinesiophobia: TSK) as well as the modified fall efficacy scale (FES). The latency times (msec) measured the time it took for a subject to respond to a translation., Results: Overall, the results of the FES demonstrated a moderate negative association with the TSK (r = -0.52, p = 0.004). There was a significant group difference for the FES (t = 2.78, p = 0.01). The FES demonstrated significant positive correlation coefficients (ranging from 0.40 to 0.51) and significant negative correlation coefficients (ranging from -0.41 to -0.61), except for the slow perturbations. The groups demonstrated a significant interaction on consecutive latency times and limb side (F = 5.84, p = 0.02). The latency time during the fast perturbations on the dominant limb (F = 5.53, p = 0.02) was significantly shorter in the kinesiophobia group., Significance: The control group demonstrated confidence during fall-related activities, but the latency times were significantly different between groups when considering the dominant limb following repeated slip perturbations. The kinesiophobia group demonstrated shorter latency times on the dominant limb to protect against potential fall-risks from perturbations. The group interactions on limb side and consecutive perturbations need to be considered with fall-related confidence and improved standing balance in older adults with kinesiophobia., Competing Interests: Declaration of Competing Interest We, the undersigned, declare that this manuscript is original, has not been published before, and is not currently being considered for publication elsewhere. We wish to confirm that there are no known conflicts of interest associated with this publication, and there has been no significant financial support for this work that could have influenced its outcome. We confirm that the manuscript has been read and approved by the author and that there are no other persons who satisfied the criteria for authorship, but are not listed. I further confirm that the order of authors listed in the manuscript has been approved by me. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are no impediments to publication, including the timing of publication, with respect to intellectual property. In so doing, I confirm that I have followed the regulations of our institutions concerning intellectual property. We understand that the Corresponding Author is the sole contact for the Editorial process (including Editorial Manager and direct communications with the office). I am responsible for communicating about progress, submissions of revisions, and final approval of proofs. I confirm that I have provided a current, correct email address which is accessible by the corresponding author, and which has been configured to accept email from the Journal., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Cancer care professionals need to be aware of kinesiophobia, fear of motion, in patients undergoing cancer therapy. The new instrument the Tampa-Scale Kinesiophobia Symptoms (TSK-Symptoms) aims to measure fear and avoidance of motion in relation to multiple symptoms (eg, nausea, fatigue, anxiety, pain). It is modified from the TSK, which relates solely to pain. Aim: To test the feasibility of the TSK-Symptoms, to quantify kinesiophobia in patients with cancer, to study whether kinesiophobia was associated with symptoms or physical activity, and through interviews to gain a deeper understanding of patient experiences. Methods: In this preparatory longitudinal study, patients (n = 55, mean age 68 years; 51% men; 38% had prostate cancer, 23% breast cancer) undergoing radiotherapy provided questionnaire data on kinesiophobia using the new instrument TSK-Symptoms, symptoms and physical activity twice (at baseline, T1, and 1 week later, T2). Eight patients were interviewed. Results: At T1 and T2, 4 of 54 (7%) and 8 of 55 patients (14%) reported kinesiophobia ( P  = .009). From T1 to T2, occurrence of nausea increased. Of the 16 nauseated patients at T2, 6 (38%) reported kinesiophobia compared to 2 (5%) of the 39 nausea-free patients ( P  = .005). Patients who reported kinesiophobia practiced less physical activity (median 0 days at moderate intensity at T1 ( P  < .001), median 2 days at moderate intensity at T2, P  = .006) compared to patients free from kinesiophobia (median 4 and 5 days). Three qualitative content analysis categories described patient experiences: (1) "Struggling to stay physically active in an extraordinary situation associated with burdensome symptoms," (2) "Feeling damaged and at the same time grateful," and (3) "Needing support due to fear of motion and of worsened condition." Conclusions: This preparatory study showed that the new instrument the TSK-Symptoms was feasible for use in patients undergoing cancer therapy to quantify kinesiophobia, which was present in approximately 1 in 10 patients. Kinesiophobia was more common in patients with nausea, and patients reporting kinesiophobia practiced less physical activity. Patients highlighted a need for support. The psychometric properties of the TSK-Symptoms, completed on several languages, need to be evaluated. Cancer care professionals may quantify kinesiophobia using the TSK-Symptoms instrument and give kinesiophobic patients support., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Specific stabilisation exercises (SSE) can combat the debilitating effects of chronic non-specific low back pain (CLBP), improve disability, pain and fear-avoidance beliefs (FAB)., Objective: To elicit the determinants of outcome in patients with CLBP with associated FABs after treatment with SSE., Method: Twenty-nine patients (20 females) with CLBP were classified using FAB questionnaire into high or low Work and Physical Activity (PA) subscales. After 4-week treatment, evaluations were done for pain, disability and lumbar spine active range of motion (AROM). Data was analysed exploratory-descriptively with a significance level set at p< 0.05., Results: Participants were aged 55.24 ± 11.91 years. They scored 19 (65.5%) and 5 (17.2%) respectively on Work and PA subscales. The post-intervention evaluation showed significant differences in all outcomes, but no significant difference between patients with high or low FAB scores for both subscales. PA scores correlated significantly with pain while work scores correlated significantly with disability. Participants' gender predicted disability, pain and AROM with moderate to large effect sizes., Conclusion: SSE can potentially improve disability, pain and range of motion for patients with chronic low back pain regardless of FABQ status. Gender and baseline patient status are potential determinants of outcome of treatment using SSE.

Objective: Within the scope of our study, it was conducted to examine kinesiophobia and fear of falling in elderly individuals staying in nursing homes., Patients and Methods: Our study was conducted with 175 elderly individuals who stayed in nursing homes affiliated with the Ministry of Family and Social Policies in Ankara, Bolu, and Düzce provinces between January 2021 and April 2021. After the demographic information was obtained, the anxiety/fear of falling was evaluated with the Falls Efficacy Scale International (FES-I), kinesiophobia with the Tampa Kinesiophobia Scale, and the depression levels with the Beck Depression Scale., Results: A significant correlation was found between depression levels (p=0.023). A significant correlation was found between the anxiety/fear of falling and the number of chronic diseases, increasing age, female gender, and assistive device use (p=0.011). While there was a significant correlation between having a chronic illness, increasing age, the use of assistive devices, the presence of falls, and kinesiophobia, a significant negative correlation was found with physical activity (p=0.033)., Conclusions: As a result, while falling individuals had an increased kinesiophobia, it was observed that individuals with increased kinesiophobia had more anxiety/fear of falling, and individuals with this condition had higher levels of depression.

The aim of this study was to create a Polish adaptation of the Tampa Scale of Kinesiophobia considering fatigue, and to verify the usefulness of the scale in the context of pain in cancer patients. The study was conducted at the Breast Cancer Unit, operating at the Greater Poland Cancer Centre, and at the Poznan Centre for Specialist Medical Services in Poznan. After considering the exclusion criteria, 100 people qualified for the interviews for the final study: 50 breast cancer patients and 50 healthy respondents (without cancer). Statistical analysis of the CFA score showed that the chi-square test was not significant (χ 2 = 10.243, p = 0.332), indicating an acceptable fit of items across scales. The reliability of the internal consistency of the scales was tested by examining the Cronbach's alpha scores for each question/statement. The mean values for this indicator were 0.74 for the pain-related scale and 0.84 for the fatigue-related scale. Construct validity was confirmed for the scales; AVE for the pain-related scale was 0.64 and for the fatigue-related scale was 0.68. The results suggest the validity of examining kinesiophobia in the context of pain- and fatigue-related mobility anxiety among breast cancer patients in Poland, and that the Tampa Scale of Kinesiophobia can be adapted for different dimensions of the condition. Both versions of the scale demonstrated adequately prepared parametric constructs, and all correlations showed a statistically significant relationship ( p < 0.05). The use of the Tampa Scale of Kinesiophobia in oncology patient studies in Poland may ultimately improve rehabilitation programs and enable the development of strategies to assist patients in supporting treatment to reduce movement anxiety.

Kinesiophobia is related with adverse outcomes in various diseases, but it has not been studied in chronic heart failure (CHF). Fatigue often causes movement avoidance in CHF patients, and thereby, leads to a worsening of condition and increasing severity of symptom burden. The purpose of this study was to explore kinesiophobia and its related factors and the relationship between the kinesiophobia and fatigue in CHF patients. We recruited (n = 236) inpatients with CHF from October 2020 to March 2021 and administered a self-designed demographic questionnaire, the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart-C), and the Multidimensional Fatigue Inventory (MFI-20), and collected related electronic medical record data. Findings revealed that 63% of participants had kinesiophobia. was a moderate correlation between fatigue and kinesiophobia ( r  = .49, p  < .01). Educational background, monthly family income, disease course, and fatigue explained 41% of the variance in kinesiophobia, of which fatigue independently accounted for 9%.

Exercise sensitivity, fear of physical sensations of exertion, is particularly elevated in individuals with cardiovascular disease and can promote fear-avoidance of physical activity. We developed an ACT-informed exposure intervention to target exercise sensitivity, called Behavioral Exposure For Interoceptive Tolerance (BE-FIT). In this Stage I pilot trial, we developed and evaluated the feasibility, safety, and initial efficacy of BE-FIT in low active patients with elevated exercise sensitivity enrolled in outpatient cardiac rehabilitation. BE-FIT is a 6-session, manualized, program-adjunctive treatment delivered during the initial weeks of cardiac rehabilitation and involves exposure to feared bodily sensations and exercise situations, bolstered by acceptance and values-focused processes. Patients ( M age = 70.7 years) were assigned to BE-FIT (n = 12) or an activity monitoring-only control (n = 7). Patients in the BE-FIT condition reported high satisfaction, completed 100% of sessions, and 86.3% ( SD  = 16.4%) of homework exposures. There were no adverse events reported. BE-FIT produced large-sized effects on reductions in exercise sensitivity and increases in both average steps/day and moderate-to-vigorous physical activity (MVPA) mins/day, from baseline to end-of-treatment. In contrast, the monitoring-only cohort evidenced small-sized reductions in exercise sensitivity and no change in average steps/day or MVPA mins/day. BE-FIT is safe, feasible, acceptable with promising findings from this Stage I trial.

Objective: This study is designed to investigate the status of kinesiophobia and related factors in cancer patients with totally implantable venous access ports (TIAPs)., Methods: This is a cross-sectional study; all the participants were recruited from the Oncology Department and the Daytime Chemotherapy Center, Renji Hospital, Shanghai Jiao Tong University School of Medicine, from April 1 to May 31, 2021. The participants were interviewed by researchers using the self-made general information questionnaire and the Tampa Scale of Kinesiophobia-11 (TSK-11) scale, which allows the fear of movement to be quantified. Eligible patients were aged ≥ 18 years, confirmed with cancer, and implanted with a port. The logistic regression model was used to evaluate clinical factors and the risk of kinesiophobia., Results: A total of 282 patients were recruited (aged 58.0 ± 11.5 years), of which gastrointestinal cancer accounted for 54.6%, breast cancer accounted for 22.7%, lung cancer accounted for 11.3%, and other types accounted for 11.3%. The TSK-11 score of the 282 patients was 17.84 ± 6.06 points, 45.7% of the patients reported mild kinesiophobia (TSK-11 ≥ 18), 18.4% of the patients reported moderate to severe kinesiophobia (TSK-11 ≥ 25), and the highest score reached 34 points. Results of logistic regression analysis showed that exercise habits (P = 0.025), pain (P = 0.023), and foreign body sensation (P = 0.003) were the risk factors of kinesiophobia., Conclusion: Kinesiophobia is common in cancer patients with TIAPs, and it is closely related to the subjective experience of daily activities, which requires more attention and early intervention to reduce the potential adverse effects., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Many patients live with long-term deficits in knee function after an anterior cruciate ligament reconstruction (ACLR). However, research is inconclusive as to which physical performance measure is most strongly related to long-term patient-reported outcomes after ACLR., Hypothesis: Quadriceps strength would be most strongly associated with patient-reported long-term outcomes after ACLR., Study Design: Cross-sectional study., Level of Evidence: Level 3., Methods: A total of 40 patients (29 female) consented and participated an average of 10.9 years post-ACLR (range, 5-20 years). Patients completed the Lower Extremity Functional Scale (LEFS), the International Knee Documentation Committee (IKDC) Scale, Knee injury and Osteoarthritis Outcome Score Quality of Life (KOOS QoL) and Sport (KOOS Sport) subscales, and the Tampa Scale of Kinesiophobia (TSK-17). Each patient subsequently performed maximal isometric quadriceps contraction, a 60-second single-leg step-down test, and the single-leg single hop and triple hop for distance tests. Multivariate linear and logistic regression models determined how performance testing was associated with each patient-reported outcome when controlling for time since surgery, age, and TSK-17., Results: When controlling for time since surgery, age at the time of consent, and TSK-17 score, maximal isometric quadriceps strength normalized to body weight was the sole physical performance measure associated with IKDC ( P < 0.001), KOOS Sport ( P = 0.006), KOOS QoL ( P = 0.001), and LEFS scores ( P < 0.001). Single-leg step-down, single hop, and triple hop did not enter any of the linear regression models ( P > 0.20). Additionally, TSK-17 was associated with all patient-reported outcomes ( P ≤ 0.01) while time since surgery was not associated with any outcomes ( P > 0.05)., Conclusion: Isometric quadriceps strength and kinesiophobia are significantly associated with long-term patient-reported outcomes after ACLR., Clinical Relevance: These results suggest that training to improve quadriceps strength and addressing kinesiophobia in the late stages of recovery from ACLR may improve long-term self-reported function.

The Fear-Avoidance Model was developed with patients who had sustained neck and back injuries and describes a cascade of events after pain that is perceived as threatening, which may lead to avoidance of valued and meaningful life activities. The literature examining burn survivors suggests they may experience fear-avoidance, however, their lived experience has yet to be thoroughly explored and the evaluation tool that has been used is four items extracted from the Tampa Scale of Kinesiophobia that were modified for burn survivors, but never formally validated with this population. Therefore, the aim of this study was to explore, through a mixed methods approach, the lived experience of burn survivors with respect to fear-avoidance and determine whether the reduced four question Tampa Scale of Kinesiophobia (4TSK) reflects and accurately measures their experience. Burn survivors (n = 17) who had undergone surgical debridement and grafting were recruited. They completed the reduced 4TSK and participated in an in-depth interview to explore their lived experience regarding fear-avoidance and their opinions on the relevance of the questions. The interviews were analyzed using a thematic-analysis approach. Five major themes that represented the lived experience of fear-avoidance in burn survivors were identified: perceived vulnerability to re-injury, others as fear influencers, difficulties & hardships during recovery, engagement in activity, and active thoughts. Based upon the interviews researchers identified 9 potential fear-avoidant participants, which differed from the screening results from the reduced 4TSK (n = 12). Overall, this study demonstrated the potential uniqueness of the burn survivor population and provided insight into their lived experience of fear of movement or activities., (Copyright © 2020 Elsevier Ltd and ISBI. All rights reserved.)

Introduction: Kinesiophobia, the fear of physical movement and activity related to injury vulnerability, has been linked to sub-optimal outcomes following total knee replacement (TKR). This systematic review has two aims: to define the relationship between kinesiophobia and functional outcomes, pain and range of motion following TKR, and to evaluate published treatments for kinesiophobia following TKR., Materials and Methods: A primary search of electronic databases, grey literature, and trial registries was performed in March 2020. English-language studies recruiting adult primary TKR patients, using the Tampa Scale of Kinesiophobia (TSK) were included. Outcome measures were grouped into short (< 6 months), medium (6-12 months), and long term (> 12 months). Study quality was assessed using the Newcastle Ottawa Scale for cohort or case control studies, and the Cochrane Collaboration Risk of Bias tool for randomised controlled trials., Results: All thirteen included papers (82 identified) showed adequately low risk of methodological bias. TSK1 (activity avoidance) correlated with WOMAC functional score at 12 months in three studies (r = 0.20 p < 0.05, R = 0.317 p = 0.001, and correlation coefficient 0.197 p = 0.005). TSK score significantly correlated with mean active range of motion (ROM) at 2 weeks [65.98 (SD = 14.51) versus 47.35 (SD = 14.48) p = 0.000], 4 weeks [88.20 (SD = 15.11) versus 57.65 (SD = 14.80) p = 0.000], and 6 months [105.33 (SD = 12.34) versus 85.53 (SD = 14.77) p = 0.000] post-operation. Three post-operative interventions improved TSK score vs control following TKR: a home-based functional exercise programme [TSK - 14.30 (SD = 0.80) versus - 2.10 (SD = 0.80) p < 0.001], an outpatient cognitive behavioural therapy (CBT) programme [TSK 27.76 (SD = 4.56) versus 36.54 (SD = 3.58)], and video-based psychological treatment [TSK 24 (SD = 5) versus 29 (SD = 5) p < 0.01]., Conclusions: Kinesiophobia negatively affects functional outcomes up until 1 year post-operatively, while active ROM is reduced up to 6 months post-procedure. Post-operative functional and psychological interventions can improve kinesiophobia following TKR.

Background : Fear of Harm (FoH) predicts return to sports in Anterior Cruciate Ligament Reconstruction (ACLR) and can be assessed using the Photographic Sports Activities for ACLR (PHOSA-ACLR). This study was conducted to determine whether FoH assessed using the PHOSA-ACLR is a latent trait, and to analyze differences in PHOSA-ACLR in athletes with or without an ACL rupture. Methods : Three convenience samples completed the PHOSA-ACLR: (1) ACLR patients ( n = 58; mean age 25.9 years; range 17-56; SD = 8.2; 43% male); (2) first year Physical Therapy (PT) students ( n = 169; mean age = 19.2; SD = 2.0; 48% male), and (3) junior football players ( n = 30; mean age = 18.3; range 17-20; SD = 3.2; 94% males). ACLR patients additionally reported functioning and Fear of Movement. PHOSA-ACLR items were analyzed with Item Response Theory using the Graded Response Model (GRM). Differences between three groups of participants were analyzed using Univariate Analysis of Variance. Results : Data fitted the two-parameter GRM, and therefore the items of the PHOSA-ACLR constitute a latent trait. There was a significant difference between the three groups in PHOSA-ACLR after controlling for age and gender (F (2, 255) = 17.1, p < 0.001). PT students reported higher levels of FoH compared to either ACLR patients or healthy soccer players. Conclusions: PHOSA-ACLR items constitute a latent trait of FoH for ACLR-specific movements. Contrary to expectations, PHOSA-ACLR is higher in first year physiotherapy students compared to patients rehabilitating from ACLR, and healthy junior soccer players.

Objectives: To determine whether knee confidence, fear of movement, psychological readiness to return-to-sport or pain are associated with patient-reported and performance-based function and return to pivoting sport in individuals one-year after anterior cruciate ligament reconstruction (ACLR)., Design: Cross-sectional study., Setting: University-laboratory., Participants: 118 individuals one-year post-ACLR., Main Outcome Measures: The KOOS-sport/recreation and IKDC and three hopping tasks were used to assess patient-reported and performance-based function, respectively. Questions regarding return to pivoting sport assessed return-to-sport status. Fear of movement (Tampa Scale), knee confidence (an item from KOOS, Visual Analogue Scale-VAS confidence during hopping tasks), knee pain (KOOS-pain, VAS pain during hopping tasks) and psychological readiness to return-to-sport (ACL-RSI) were also assessed., Results: Worse fear of movement (p = 0.019), KOOS-pain (p < 0.001), ACL-RSI (p < 0.001), task-specific knee confidence and pain were associated with poorer patient-reported function. Worse task-specific knee confidence (p < 0.001) and pain (p < 0006) and ACL-RSI (p < 0.016) were associated with poorer performance-based function. Higher ACL-RSI scores were associated with higher odds of returning to pivoting sport one-year post-ACLR (p < 0.001)., Conclusion: Individual's fear of movement, knee confidence, psychological readiness to return-to-sport and pain are related to function. Evaluating and considering knee confidence, fear of movement, and psychological readiness should be an important part of comprehensive post-ACLR rehabilitation., (Copyright © 2019. Published by Elsevier Ltd.)

Background and Objectives: Low back pain (LBP) is one of the leading forms of chronic pain and is among the leading causes of pain and disability. In this study, we investigated the associations between the severity of disability and fear of movement and pain beliefs as well as the impact of the fear of movement and pain beliefs on the quality of life in patients with chronic LBP., Methods: A total of 89 patients (42.29 ± 16.05 years) with chronic low back pain were included in the study. The instruments used in the assessments include the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Tampa Kinesiophobia Scale (TKS), the Pain Belief Questionnaire (PBQ), and the SF 36-Short Form. Patients were assigned into three groups by disability severity based on ODI scores. Statistical analysis was performed using SPSS 15., Results: No statistically significant intergroup differences were found in TKS and PBQ scores (p> 0.05). A positive correlation was found between TKS scores, age (r: 0.227/p< 0.05), PBQ organic (r: -0.250/p< 0.05) scores., Conclusions: Our study revealed high levels of kinesiophobia and similar pain beliefs, independent of the severity level of disability. We believe that cognitive-behavioral therapy that may reduce fear-avoidance behaviors and convert negative pain beliefs into positive ones should be added to rehabilitation procedures for LBP.

Purpose: Dyspnea, sedentary lifestyle, and comorbid diseases may reduce the desire to engage in physical movement in chronic obstructive pulmonary disease (COPD). The aims of this study were to assess levels of kinesiophobia among stable COPD patients and evaluate the relationship between kinesiophobia and pain and fatigue severity, dyspnea level, and comorbidities in this patient group. Material and Methods: Thirty-one patients with moderate/severe COPD and thirty-one age- and sex-matched healthy controls participated in the study. All participants were assessed using Visual Analog Scale for pain severity, Fatigue Severity Scale, modified Medical Research Council Dyspnea Scale, Charlson Comorbidity Index, and Tampa Scale of Kinesiophobia. Results: Ninety-three percent of the patients with COPD had a high degree of kinesiophobia (Tampa Scale of Kinesiophobia score >37). The modified Medical Research Council Dyspnea Scale, Charlson Comorbidity Index, and Tampa Scale of Kinesiophobia scores of patients with COPD was significantly higher than those of healthy subjects ( p  < 0.001). Tampa Scale of Kinesiophobia score was significantly associated with modified Medical Research Council Dyspnea Scale score ( r  = 0.676, p  < 0.001), Charlson Comorbidity Index score ( r  = 0.746, p  < 0.001) and fatigue severity level ( r  = 0.524, p  = 0.005). Conclusion: Most moderate/severe COPD patients express fear of movement. Kinesiophobia is strongly associated with dyspnea perception, fatigue severity, multisystemic comorbidities in COPD. Further studies are needed to determine the effects of kinesiophobia on the success of pulmonary rehabilitation. Implications for rehabilitation Most of moderate-to-severe chronic obstructive pulmonary disease patients have fear of movement. Increase fear of movement in moderate-severe chronic obstructive pulmonary disease is associated with increased dyspnea perception and fatigue severity and multisystemic comorbidities.

Background: Work-related fear avoidance beliefs play an important role when considering subjective work ability among people with back pain. Pain-related self-efficacy is known as a predictor for physical activity and subjective work ability., Objectives: The present longitudinal study aims to investigate the relationships between work-related fear avoidance beliefs, pain-related self-efficacy, and subjective work ability among back pain patients., Materials and Methods: A total of 93 people with back pain (M = 35.58 years, SD = 13.45; range: 18-69) were assessed at baseline and 4 weeks later. Of the participants, 54.83% (n = 51) were female. Data analysis was performed with SPSS 25 using descriptive statistics and multiple regression methods., Results: Work-related fear avoidance beliefs were negatively related with subjective work ability at baseline. Pain-related self-efficacy moderated this relationship. The relationship was stronger at low and medium levels of pain-related self-efficacy. The moderation effect was not found when considering subjective work ability after 4 weeks., Conclusion: Work-related fear avoidance beliefs among back pain patients seem to be important for subjective work ability in the short term. This especially holds true when patients have low self-efficacy beliefs. The investigated constructs should be emphasized in the patient-centered therapy. Longitudinal studies with larger samples and more frequent follow-ups should be investigated in future studies.

Purpose: We aimed to kinematically analyze lumbar bending and returning movements and clarify the relationship between fear of movement and kinematic output., Methods: We recruited 45 participants with CLBP (i.e., > 6 months) and 20 healthy control (HC) participants with no history of CLBP. We used the numerical rating pain scale (NRS), Tampa Scale for Kinesiophobia (TSK-11), and Pain Self-Efficacy Questionnaire (PSEQ-2) as qualitative outcome measurements. CLBP participants were divided into two subgroups (high- and low-fear groups) based on the median split of the total TSK-11 score. In the kinematic recording session, a starting-cue beep signaled participants to bend forward using the lumbar region of their spine and then return to an upright posture, and we used a flexible twin-axis electrogoniometer to record the lumbar movements. The time series of lumbar movements was divided into four phases according to lumbar movement velocity, and we calculated the length (sec) of each phase., Results: Phase 1 (duration prior to cue-induced movement initiation) and phase 3 (switch in the direction of lumbar movement from forward to backward) were significantly longer in the CLBP high-fear group compared with those in the CLBP low-fear group and HC group (p < 0.05). The increased lengths of these two phases were positively correlated with not only pain intensity but also TSK-11 scores (p < 0.05)., Conclusions: These results represent evidence of a particular lumbar movement pattern associated with kinesiophobia. These results might help to identify psychological factors that impact lumbar movement patterns in individuals with CLBP. These slides can be retrieved under Electronic Supplementary Material.

Background: Little is known about the correlates between pain intensity (PI) and physical function (PF) and psychosocial factors {kinesiophobia (K), Pain Catastrophizing (PC) and Self-efficacy (SE)} among patients diagnosed with knee osteoarthritis in developing countries like Nigeria., Objective: To investigate the correlates of PI and PF and psychosocial factors in patients with knee osteoarthritis in Nigeria., Design: Eighty-nine consecutively sampled patients diagnosed with knee osteoarthritis from three selected public hospitals in Enugu, South-East Nigeria, participated in this cross-sectional survey., Method: Brief Fear of Movement Scale for Osteoarthritis, Pain Catastrophizing Scale and Arthritis Self-Efficacy Scale-8 item were used to assess kinesiophobia, pain catastrophizing and Self-efficacy respectively. Visual Analogue Scale and Ibadan Knee or Hip Osteoarthritis Measure were used to assess PI and PF respectively. Data were analysed using Pearson's correlation coefficient and multiple regression at p = 0.05., Results/findings: Participants were aged 59.11 ± 12.46years involving male (17.9%) and female (82.1%) participants. There were no significant gender differences in the scores of kinesiophobia, PI, PF, PC and self-efficacy. Pain intensity was significantly proportional to kinesiophobia (r = 0.38), and PC(r = 0.39). Better physical function was associated with high self-efficacy (r = 0.35), low kinesiophobia (r = -0.43) and low PC(r = -0.28). Significant predictive markers of PI included kinesiophobia (β = 0.24) and PC(β = 0.11) while that of PF, included kinesiophobia (β = -0.41) and SE(β = 2.39)., Conclusions: Kinesiophobia and pain catastrophizing correlate and predict PI significantly. Kinesiophobia and SE are significant correlates and predictors of PF among patients with knee osteoarthritis in Nigeria., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: To examine the association of fear avoidance and self-efficacy psychological factors within 4 weeks after anterior cruciate ligament (ACL) reconstruction with knee impairment resolution and readiness for advanced rehabilitation at 12 weeks post-surgery., Methods: Seventy-five patients participated. Data collection included demographics; questionnaires on fear avoidance (Pain Catastrophizing Scale, PCS; shortened Tampa Scale for Kinesiophobia, TSK-11) and self-efficacy (modified Self-Efficacy for Rehabilitation Outcome Scale, SER; Knee Activity Self-Efficacy, KASE) at 1, 4, and 12 weeks post-surgery; and knee impairment measures (pain intensity, range of motion, and quadriceps symmetry index) at 12 weeks post-surgery. Readiness for advanced rehabilitation (READY or NOT READY) was determined by knee impairment resolution criteria; demographics and questionnaire scores were compared between groups. Questionnaire scores at 1 and 4 weeks post-surgery and the change between time points were examined for association with knee impairment measures and group assignment., Results: READY included 32 patients; NOT READY included 43 patients. Questionnaire scores improved in both groups over time. Significant correlations across groups were: PCS scores at 1 and 4 weeks post-surgery with pain intensity at 12 weeks post-surgery (r = 0.24 and 0.29, respectively) and KASE score 4 weeks post-surgery with range of motion deficit at 12 weeks post-surgery (r = - 0.26). Contact injury was more prevalent in READY. After accounting for mechanism of injury, higher TSK-11 and fear of re-injury subscale scores at 4 weeks post-surgery increased the odds of NOT READY assignment at 12 weeks post-surgery (odds ratios 1.10 and 1.31, respectively)., Conclusions: Lower pain catastrophizing and higher knee activity self-efficacy levels 4 weeks after ACL reconstruction were associated with better knee impairment resolution at 12 weeks post-surgery, whereas lower kinesiophobia at 4 weeks post-surgery increased the odds of meeting advanced rehabilitation criteria at 12 weeks post-surgery. The clinical implication of these findings is that measuring pain catastrophizing, knee activity self-efficacy and kinesiophobia at 4 weeks post-surgery may improve prediction of patients at risk for delayed rehabilitation progression 12 weeks post-surgery., Level of Evidence: III.

Background: Kinesiophobia is an important problem that increases neck pain and causes it to become chronic., Objective: This study aims to compare the relationship between pain, quality of life, and kinesophobia in non-specific chronic neck pain., Methods: In total 87 patients were included in the study. Pain was assessed with Visual Analog Scale (VAS), kinesiophobia with Tampa Kinesiophobia Scale (TKS), and quality of life with Health Status Questionnaire Short Form-36 (SF-36)., Results: The median age was 50 (40-59) years and the median complaint duration was 12 (8-48) months. The median value of VAS at rest was 4 (2-6) and the median value of VAS during the activity was 7 (5-8). The median TKS scores were 41 (39-45), the median SF-36 general health scores were 61 (45-75), and the median SF-36 mental health scores were 72 (52-80). There was a weak correlation between the TSK scores and gender, education level, and SF-36 general health scores (r= 0.206, p= 0.023; r=-0.235, p= 0.004; r= 0.236/p= 0.027 respectively). There was no relationship between kinesiophobia and the other variables., Conclusion: TSK scores showed a correlation with gender, education level, and SF-36 general health scores. We conclude that as the education level decreases, kinesophobia scores increase, and as kinesophobia scores increase, the quality of life decreases.

Total hip arthroplasty (THA) improve the patients' quality of life, and one of the most important problems after surgery is to optimize postoperative pain management. It has been shown that pain is intimately linked to the fear of movement, the so-called kinesiophobia, which can affect the entire perioperative period and quality of life in people undergoing THA. In this study, we aimed to present a new integrative approach called IARA model specifically focused on educational interventions such as knowledge and awareness of illness, guided imagery, and drawings to help the patient achieve full autonomy and confidence about the perioperative period and surgery. The Hip Injury and Osteoarthritis Outcome Score (HOOS), Tampa Scale Kinesiophobia (TSK) questionnaire, and Numeric Rating Scale 0-10 have been used to test the efficacy of IARA. The main finding in the present study was the effectiveness of IARA model in improving indexes of pain (p < 0.01) and QoL (p < 0.01) and to keep kinesiophobia levels low in patients undergoing THA.

Purpose: Fear of reinjury is an important factor in determining who returns to sport following anterior cruciate ligament reconstruction (ACLR). Evidence from other musculoskeletal injuries indicates fear of reinjury may be related to stiffened movement patterns observed in individuals following ACLR. The relationship between fear of reinjury and performance on dynamic tasks, however, has not been investigated. Therefore, the purpose of this study was to investigate the relationship between fear of reinjury and jump-landing biomechanics., Methods: Thirty-six females (height = 168.7 ± 6.5 cm, body mass = 67.2 ± 10.0 kg, age = 18.9 ± 1.5 years) with a history of ACLR (time from surgery = 26.1 ± 13.3 months) participated in the study. Each participant performed five trials of a standard jump-landing task. 3D motion capture and surface electromyography was used to record peak kinematics and lower extremity muscle activation on the injured limb during the jump landings. Spearman's rank correlations established the relationship between TSK-11 scores and each biomechanical variable of interest., Results: There was a significant, negative relationship between fear of reinjury (TSK-11: 19.9 ± 4.5) and knee (p = 0.006), hip (p = 0.003), and trunk flexion (p = 0.013). There was also a significant, positive relationship between hip adduction (p = 0.007), and gluteus maximus preparatory activation (p = 0.001)., Conclusions: The results of this study indicate that higher fear of reinjury is associated with stiffened movement patterns that are associated with increased risk of a second ACL injury. Similar movement patterns have been observed in patients with low back pain. Clinicians should evaluate psychological and emotional consequences of injury in addition to the physical consequences as they appear to be related., Level of Evidence: III.

Background: Low back pain is a significant health problem condition due to high prevalence among the general population. Emotions and physical factors are believed to play a role in chronic low back pain. Kinesiophobia is one of the most extreme forms of fear of pain due to movement or re-injury. The purpose of this study was to investigate the association between kinesiophobia and pain intensity, disability and quality of life in people with chronic low back pain., Methods: The study included 132 individuals with chronic back pain, with ages between 18 and 65 years old. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia, pain intensity was measured using the Numeric Rating Scale with a cut-off more than 3 for inclusion in the study, disability was assessed using the Roland Morris questionnaire, quality of pain was assessed using the McGill questionnaire, and quality of life was assessed using the Quality of Life questionnaire SF-36., Results: The results are statistically significant, but with weak associations were found between kinesiophobia and pain intensity (r = 0.187), quality of pain (sensory, r = 0.266; affective, r = - 0.174; and total r = 0.275), disability (r = 0.399) and physical quality of life (emotional r = - 0.414)., Conclusion: Kinesiophobia is an important outcome to assess in patients with chronic low back pain. The results suggest that correlations between kinesiophobia and disability and quality of life are statistically significant.

Purpose: Fear of physical activity (FoPA) has been suggested as a psychological barrier to exercise-based cardiac rehabilitation and everyday physical activity (PA) in patients with heart failure (HF). We evaluated the recently developed Fear of Activity in Situations-Heart Failure (FActS-HF) questionnaire that assesses affective/cognitive fear reactions to situations of varying PA intensities., Methods: The FActS-HF was given to 132 ambulatory patients with stable HF (67 ± 12 years, 80% men). In 121 participants with valid FActS-HF data, the questionnaire's dimensionality was investigated. Psychometric properties were determined in terms of reliability and validity. We assessed convergent and discriminant correlations of FoPA with anxiety, kinesiophobia, and depression. External validation criteria encompassed clinical variables and objectively assessed accelerometer measures of everyday PA in a subsample of 61 participants., Results: The FActS-HF measures a unidimensional construct (i.e., FoPA) based on items presenting varying PA intensities (i.e., the more intense the PA, the stronger the fear response). The scale demonstrated good 2-week stability (r tt  = 0.82) and excellent internal consistency reliability (α = 0.97). FoPA was moderately to strongly associated with anxiety and kinesiophobia, and weakly to moderately associated with state/trait depression, supporting convergent and discriminant validity, respectively. High FoPA was associated with feeling uninformed about HF, comorbidities, non participitation to cardio fitness groups, and less stair climbing, as measured by accelerometry., Conclusion: The FActS-HF is a reliable and valid instrument to measure FoPA in patients with HF and provides a promising tool for further research and practice.

The virtual immersive gaming to optimize recovery (VIGOR) study is a randomized controlled trial of the effects of virtual reality games to encourage lumbar spine flexion among individuals with chronic low back pain and fear of movement. Whereas traditional graded activity or graded exposure therapies for chronic low back pain have high attrition and poor long-term efficacy, we believe that virtual reality games have distinct advantages that can enhance adherence and clinical outcomes. First, they are engaging and enjoyable activities that can distract from pain and fear of harm. In addition, because they gradually reinforce increases in lumbar spine flexion to achieve game objectives, continued engagement over time is expected to promote recovery through restoration of normal spinal motion. The study design includes two treatment groups which differ in the amount of lumbar flexion required to achieve the game objectives. All participants will play the games for nine weeks, and pre-treatment to 1-week post-treatment changes in pain and disability will serve as the co-primary clinical outcomes. In addition, changes in lumbar flexion and expectations of pain/harm will be examined as potential treatment outcome mediators. Maintenance of treatment outcomes will also be assessed for up to 48-weeks post-treatment. In brief, we hypothesize that the virtual reality games will reduce pain and disability by promoting spinal motion and allowing participants to develop an implicit understanding that they are capable of engaging in significant lumbar spine motion in their daily lives without a risk of injury to their back., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Study Design Single case report with repeated measures over 18 months. Background Management of persistent low back pain (PLBP) associated with high pain-related fear is complex. This case report aims to provide clinicians with insight into the process of change in a person with PLBP and high bending-related fear, who was managed with an individualized behavioral approach of cognitive functional therapy. Case Description A retired manual worker with PLBP believed that his spine was degenerating, that bending would hurt him, and that avoidance was the only form of pain control. At baseline, he presented high levels of pain-related fear on the Tampa Scale of Kinesiophobia (score, 47/68) and a high-risk profile on the Örebro Musculoskeletal Pain Questionnaire (score, 61/100). Unhelpful beliefs and behaviors led to a vicious cycle of fear and disengagement from valued life activities. Guided behavioral experiments were used to challenge his thoughts and protective responses, indicating that his behavior was modifiable and the pain controllable. Using a multidimensional clinical-reasoning framework, cognitive functional therapy management was tailored to target key drivers of PLBP and delivered over 6 sessions in a 3-month period. Outcomes Over an 18-month clinical journey, he demonstrated improvements in bending-related fear, pain expectancy, and pain experience, and substantial changes in pain-related fear (Tampa Scale of Kinesiophobia: 33/68; change, -14 points) and risk profile (Örebro Musculoskeletal Pain Questionnaire: 36/100; change, -25 points). Clinical interviews at 6 and 18 months revealed positive changes in mindset, understanding of pain, perceived pain control, and behavioral responses to pain. Discussion This case report provides clinicians with an insight to using a multidimensional clinical-reasoning framework to identify and target the key drivers of the disorder, and to using cognitive functional therapy to address unhelpful psychological and behavioral responses to pain in a person with PLBP and high pain-related fear. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther 2017;47(9):637-651. Epub 13 Jul 2017. doi:10.2519/jospt.2017.7371.

The purpose of this study was to investigate the effects of kinesiophobia on early functional outcomes in patients following total knee arthroplasty (TKA) and how kinesiophobia is related to functional outcomes and pain. The Tampa Scale for Kinesiophobia (TSK), 2-minute walk test (2-MWT), and the timed up and go test (TUG) were used to assess 46 TKA patients on discharge day. The pain levels and active knee flexion range of motion (ROM) were recorded. Patients were divided into two groups as high kinesiophobia (Group I, n = 22) and low kinesiophobia (Group II, n = 24) based on the TSK levels. The TUG results were similar between groups (p = 0.826). 2-MWT results (p < 0.001), pain levels (p = 0.003), and knee flexion ROM (p = 0.025) scores were better in Group II when compared to Group I. The TSK scores were significantly correlated with 2-MWT results (r = -0.40; p = 0.003), pain levels (r = 0.80; p < 0.001), and knee flexion ROM (r = -0.47; p = 0.001). The regression analysis revealed that 41% of 2-MWT score, 47% of knee flexion ROM, and 60% of pain level changes could be explained by kinesiophobia level. The results suggest that early outcomes following TKA were affected by the pain-related fear of movement. The clinicians need to consider the interrelationships between fear of movement and functional outcomes when designing, implementing, and monitoring daily therapeutic exercise programs.

Context: A sports injury has both physical and psychological consequences for the athlete. A common postinjury psychological response is elevated fear of reinjury., Objective: To provide an overview of the implications of fear of reinjury on the rehabilitation of athletes, including clinical methods to measure fear of reinjury; the impact of fear of reinjury on rehabilitation outcomes, including physical impairments, function, and return to sports rate; and potential interventions to address fear of reinjury during rehabilitation., Evidence Acquisition: PubMed was searched for articles published in the past 16 years (1990-2016) relating to fear of reinjury in athletes. The reference lists of the retrieved articles were searched for additionally relevant articles., Study Design: Clinical review., Level of Evidence: Level 3., Results: Fear of reinjury after a sports injury can negatively affect the recovery of physical impairments, reduce self-report function, and prevent a successful return to sport. Athletes with high fear of reinjury might benefit from a psychologically informed practice approach to improve rehabilitation outcomes. The application of psychologically informed practice would be to measure fear of reinjury in the injured athletes and provide interventions to reduce fear of reinjury to optimize rehabilitation outcomes., Conclusion: Fear of reinjury after a sports injury can lead to poor rehabilitation outcomes. Incorporating principles of psychologically informed practice into sports injury rehabilitation could improve rehabilitation outcomes for athletes with high fear of reinjury.

Background: Approaches in the treatment of general chronic low back pain (CLBP) are multifaceted relative to specific interventions. In the past, passive interventions have commonly been employed with little evidence to support their effectiveness. Recent reviews suggest a focus on active exercises programs that includes pain education and cognitive behavioral therapy., Objective: To investigate the outcomes of CLBP patients and describe the approach in persons undergoing a group spinal rehabilitation program using graded exercise, and operant conditioning., Methods: Adult patients with CLBP participated in a twice weekly 90 minute exercise sessions for 8-weeks (n= 201). The program consisted of behavioral education, stretching, aerobic exercises, graded progressive resistance exercise, MedX isotonic strengthening, and functional bending lifting task exercises., Results: A total of 201 patient records were evaluated where the overall ODI improvement was 13.2% (± 14.0) (p< 0.001). There were significant and clinically meaningful improvements in flexibility, VAS, functional lifting tasks (p< 0.001), and lumbar extension strength (p= 0.01) at 8-week follow-up. Questionnaires were delivered via mail with a 21% return rate revealed sustained improvements., Conclusion: CLBP patients undergoing an 8-week intensive exercise approach incorporating both behavioral and physical conditioning principles showed both significant and clinically significant improvements in this observational case series. Long-term benefits were also seen in both the 6 and 12 month follow-up questionnaires although further investigation is warranted due to limited survey return rate and study design.

Unlabelled: Previous studies have not examined the assessment of chronic low back pain (CLBP) and pain-related anxiety from a fear avoidance model through the use of motion-capture software and virtual human technologies. The aim of this study was to develop and assess the psychometric properties of an interactive, technologically based hierarchy that can be used to assess patients with pain and pain-related anxiety. We enrolled 30 licensed physical therapists and 30 participants with CLBP. Participants rated 21 video clips of a 3-D animated character (avatar) engaging in activities that are typically feared by patients with CLBP. The results of the study indicate that physical therapists found the virtual hierarchy clips acceptable and depicted realistic patient experiences. Most participants with CLBP reported at least 1 video clip as being sufficiently anxiety-provoking for use clinically. Therefore, this study suggests a hierarchy of fears can be created out of 21 virtual patient video clips paving the way for future clinical use in patients with CLBP., Perspective: This report describes the development of a computer-based virtual patient system for the assessment of back pain-related fear and anxiety. Results show that people with back pain as well as physical therapists found the avatar to be realistic, and the depictions of behavior anxiety- and fear-provoking., (Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.)

Unlabelled: The fear-avoidance model postulates that in an initial acute phase chronic low back pain (CLBP) patients acquire a fear of movement that results in avoidance of physical activity and contributes to the pain becoming chronic. The current functional magnetic resonance imaging study investigated the neural correlates of imagining back-straining and neutral movements in CLBP patients with high (HFA) and low fear avoidance (LFA) and healthy pain-free participants. Ninety-three persons (62 CLBP patients, 31 healthy controls; age 49.7 ± 9.2 years) participated. The CLBP patients were divided into an HFA and an LFA group using the Tampa Scale of Kinesiophobia. The participants viewed pictures of back-straining and neutral movements and were instructed to imagine that they themselves were executing the activity shown. When imagining back-straining movements, HFA patients as well as healthy controls showed stronger anterior hippocampus activity than LFA patients. The neural activations of HFA patients did not differ from those of healthy controls. This may indicate that imagining back-straining movements triggered pain-related evaluations in healthy controls and HFA participants, but not in LFA participants. Although heightened pain expectancy in HFA compared with LFA patients fits well with the fear-avoidance model, the difference between healthy controls and LFA patients was unexpected and contrary to the fear-avoidance model. Possibly, negative evaluations of the back-straining movements are common but the LFA patients use some kind of strategy enabling them to react differently to the back-straining events., Perspective: It appears that low fear-avoidant back pain patients use some kind of strategy or underlying mechanism that enables them to react with less fear in the face of potentially painful movements. This warrants further investigation because countering fear and avoidance provide an important advantage with respect to disability., (Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.)

Background: The contribution of kinesiophobia (fear of movement) to the pain experience among older adults has been poorly evaluated. The aim of this study was to study prevalence at baseline, development over a 12-month period and cognitive-affective variables of kinesiophobia in a population-based sample of older adults with chronic pain., Methods: The study included 433 older adults (+65 years) with chronic pain (mean age 74.8 years) randomly selected using a Swedish register of inhabitants. Kinesiophobia was measured at baseline and 12-month follow-up with the 11-item version of the Tampa Scale of Kinesiophobia (TSK-11). Associations of demographic-, cognitive affective - and pain-related variables to kinesiophobia were analysed with linear regression analyses., Results: The mean level of kinesiophobia was low. Worsening and recovering from kinesiophobia occurred over time, but the mean level of kinesiophobia remained unchanged (p = 0.972). High levels of kinesiophobia (TSK ≥35) were found among frailer and older adults predominately living in care homes, but not dependent on sex. Poor self-perceived health (OR = 8.84) and high pain intensity (OR = 1.22) were significantly associated with kinesiophobia., Conclusion: Results indicate that potential interventions regarding kinesiophobia among older adults should aim to decrease pain intensity and strengthen health beliefs.